To the content
2 . 2022

Immediate results of robot-assisted and laparoscopic interventions in sigmoid and rectal cancer surgery


Background. Over the past decades, laparoscopic colorectal surgery has become the new standard of care for colorectal diseases. The growing interest in robotic interventions is due to the provision of a stable 3D image from a camera controlled by the surgeon; angular instruments imitating the movement of the surgeon’s hands; good ergonomics and physiological tremor filtering.

Aim of our study was to compare the immediate results of robot-assisted and conventional laparoscopic interventions in sigmoid and rectal cancer surgery.

Material and methods. A prospective, non-randomized study included 64 patients with sigmoid and rectal tumors between September 2019 and April 2021. The main group consisted of 31 patients operated with the use of the robot; the control group consisted of 33 patients after laparoscopic interventions. All patients underwent formation of hardware colorectal anastomoses.

Results. Robot-assisted interventions were significantly longer than laparoscopic ones (263 min versus 225 min, p=0.025). Timing of abdominal drainage removal in the main group was shorter than in the comparison group (3.06 vs 4.4 days postoperatively, p=0.002). The average postoperative bed-day was 7.13 days after robot-assisted interventions and 8.33 days after laparoscopic interventions (p=0.043). In robot-assisted surgeries, more lymph nodes were removed with the pathological preparation than in laparoscopic surgeries (16.19±8.8 and 12.21±8.9, respectively, p=0.045). There were no differences between the compared groups in the volume of intraoperative blood loss, conversion rate to laparotomy, and the incidence of postoperative complications.

Conclusion. Robot-assisted resection interventions on the rectum are safe and are not inferior  in immediate results to similar laparoscopic surgeries, while eliminating most of the drawbacks  of laparoscopic surgery.

Keywords:robot-assisted surgery; colorectal surgery; rectal cancer; da Vicni robot; laparoscopic colorectal surgery

Funding. The study had no sponsor support.
Conflict of interest. The authors declare no conflict of interest.
For citation: Bedzhanyan A.L., Sumbaev A.A., Petrenko K.N., Frolova Yu.V., Temirsultanova Kh.R., Goncharov A.L., Andrey- tsev I.L. Immediate results of robot-assisted and laparoscopic interventions in sigmoid and rectal cancer surgery. Clinical and Experimental Surgery. Petrovsky Journal. 2022; 10 (2): 103–11. DOI:  (in Russian)


1.      Fowler D.L., White S.A. Laparoscopy-assisted sigmoid resection. Surg Laparosc Endosc. 1991; 1 (3): 183–8.

2.      Jayne D.G., Thorpe H.C., Copeland J., Quirke P., Brown J.M.,  Guillou P.J. Five-year follow-up of the Medical Research Council CLASICC trial of laparoscopically assisted versus open surgery for colorectal cancer. Br J Surg. 2010; 97 (11):  1638–45.

3.      van der Pas M.H.G.M., Haglind E., Cuesta M.A., Fürst A., Lacy A.M., Hop W.C.J., et al. Laparoscopic versus open surgery for rectal cancer (COLOR II): short-term outcomes of a randomised, phase 3 trial. Lancet Oncol. 2013; 14 (3): 210-8.

4.      Jeong S.Y., Park J.W., Nam B.H., Kim S., Kang S.B.,  Lim S.B., et al. Open versus laparoscopic surgery for mid-rectal or low-rectal cancer after neoadjuvant chemoradiotherapy (COREAN trial): Survival outcomes of an open-label, non-inferiority, randomised controlled trial. Lancet Oncol. 2014; 15 (7): 767–74.

5.      Kang S.B., Park J.W., Jeong S.Y., Nam B.H., Choi H.S.,  Kim D.W., et al. Open versus laparoscopic surgery for mid or low rectal cancer after neoadjuvant chemoradiotherapy (COREAN trial): short-term outcomes of an open-label randomised controlled trial. Lancet Oncol. 2010; 11 (7): 637–45.

6.      Stevenson A.R.L., Solomon M.J., Lumley J.W., Hewett P., Clouston A.D., Gebski V.J., et al. Effect of laparoscopic-assisted resection vs open resection on pathological outcomes in rectal cancer: the ALaCaRT randomized clinical trial. JAMA. 2015;  314 (13): 1356–63.

7.      Fleshman J., Branda M., Sargent D.J., Boller A.M.,  George V., Abbas M., et al. Effect of Laparoscopic-assisted resection vs open resection of stage II or III rectal cancer on pathologic outcomes: the ACOSOG Z6051 randomized clinical trial. JAMA. 2015; 314 (13): 1346–55.

8.      Mak T.W.C., Lee J.F.Y., Futaba K., Hon S.S.F., Ngo D.K.Y., Ng S.S.M. Robotic surgery for rectal cancer: a systematic review of current practice. World J Gastrointest Oncol. 2014; 6 (6): 184.

9.      Park J.S., Choi G.S., Lim K.H., Jang Y.S., Jun S.H. S052: a comparison of robot-assisted, laparoscopic, and open surgery in the treatment of rectal cancer. Surg Endosc. 2011; 25 (1):  240–8.

10.   Desouza A.L., Prasad L.M., Marecik S.J., Blumetti J., Park J.J., Zimmern A., et al. Total mesorectal excision for rectal cancer: the potential advantage of robotic assistance. Dis Colon Rectum. 2010; 53 (12): 1611–7.

11.   Xiong B., Ma L., Zhang C., Cheng Y. Robotic versus laparoscopic total mesorectal excision for rectal cancer: a meta-analysis. J Surg Res. 2014; 188 (2): 404–14.

12.   Weber P.A., Merola S., Wasielewski A., Ballantyne G.H., Delaney C.P. Telerobotic-assisted laparoscopic right and sigmoid colectomies for benign disease. Dis Colon Rectum. 2002; 45 (12): 1689–94.

13.   Lee S.H., Kim D.H., Lim S.W. Robotic versus laparoscopic intersphincteric resection for low rectal cancer: a systematic review and meta-analysis. Int J Colorectal Dis. 2018; 33 (12): 1741–53.

14.   Cui Y., Li C., Xu Z., Wang Y., Sun Y., Xu H., et al. Robot-assisted versus conventional laparoscopic operation in anus-preserving rectal cancer: a meta-analysis. Ther Clin Risk Manag. 2017; 13: 1247–57.

15.   Simillis C., Lal N., Thoukididou S.N., Kontovounisios C., Smith J.J., Hompes R., et al. Open versus laparoscopic versus robotic versus transanal mesorectal excision for rectal cancer: a systematic review and network meta-analysis. Ann Surg. 2019; 270 (1): 59–68.

16.   Jayne D., Pigazzi A., Marshall H., Croft J., Corrigan N., Copeland J., et al. Effect of robotic-assisted vs conventional laparoscopic surgery on risk of conversion to open laparotomy among patients undergoing resection for rectal cancer the ROLARR randomized clinical trial. JAMA. 2017; 318 (16): 1569–80.

17.   Robotic Surgical Systems. Da Vinci. Ion. Intuitive [Electronic resource]. URL: (date of access April 12, 2022)

18.   Miskovic D., Foster J., Agha A., Delaney C.P., Francis N., Hasegawa H., et al. Standardization of laparoscopic total mesorectal excision for rectal cancer: a structured international expert consensus. Ann Surg. 2015; 261 (4): 716–22.

19.   Doyle D.J., Garmon E.H. American Society of Anesthesiologists Classification (ASA Class). In: StatPearls. StatPearls Publishing, 2018.

20.   Trastulli S., Cirocchi R., Desiderio J., Coratti A., Guarino S.,  Renzi C., et al. Robotic versus laparoscopic approach in colonic resections for cancer and Benign diseases: systematic review and meta-analysis. PLoS One. 2015; 10 (7): e0134062.

21.   Davis B.R., Yoo A.C., Moore M., Gunnarsson C. Robotic-assisted versus laparoscopic colectomy: cost and clinical outcomes. J Soc Laparoendosc Surg. 2014; 18 (2): 211–24.

22.   Murashko R.A., Ermakov E.A., Uvarov I.B. Robotic and laparoscopic surgeries for colorectal cancer: learning curve and short-term outcomes. Tazovaya khirurgiya i onkologiya [Pelvic Surgery and Oncology]. 2017; 7 (3): 25–34. (in Russian)

23.   Feroci F., Vannucchi A., Bianchi P.P., Cantafio S., Garzi A., Formisano G., et al. Total mesorectal excision for mid and low rectal cancer: laparoscopic vs robotic surgery. World J Gastroenterol. 2016; 22 (13): 3602–10.

24.   D’Annibale A., Pernazza G., Monsellato I., Pende V., Lucandri G., Mazzocchi P., et al. Total mesorectal excision: a comparison of oncological and functional outcomes between robotic and laparoscopic surgery for rectal cancer. Surg Endosc. 2013; 27 (6): 1887–95.

25.   Park E.J., Cho M.S., Baek S.J., Hur H., Min B.S., Baik S.H., et al. Long-term oncologic outcomes of robotic low anterior resection for rectal cancer. Ann Surg. 2015; 261 (1): 129–37.

26.   Trinh B.B., Jackson N.R., Hauch A.T., Hu T., Kandil E. Robotic versus laparoscopic colorectal surgery. J Soc Laparoendosc Surg. 2015; 18 (4): e2014.00187.

27.   Alasari S., Min B.S. Robotic colorectal surgery: a systematic review. ISRN Surg. 2012; 2012: 293894.

28.   Araujo S.E.A., Seid V.E., Klajner S. Robotic surgery for rectal cancer: current immediate clinical and oncological outcomes. World J Gastroenterol. 2014; 20 (39): 14 359-70.

29.   Spinoglio G., Summa M., Priora F., Quarati R., Testa S. Robotic colorectal surgery: first 50 cases experience. Dis Colon Rectum. 2008; 51 (11): 1627–32.

30.   Gladyshev D.V., Kotiv B.N., Belyaev A.M., Karachun A.M., Murashko R.A. Russian multicenter experience of robot-assisted surgery in patients with rectal cancer. Tazovaya khirurgiya i onkologiya [Pelvic Surgery and Oncology]. 2017; 7 (3): 16–24. (in Russian)

31.   Lim D.R., Min B.S., Kim M.S., Alasari S., Kim G., Hur H., et al. Robotic versus laparoscopic anterior resection of sigmoid colon cancer: comparative study of long-term oncologic outcomes. Surg Endosc. 2013; 27 (4): 1379–85.

32.   Duan B.S., Zhao G.H., Yang H., Wang Y. A pooled analysis of robotic versus laparoscopic surgery for colon cancer. Surg Laparosc Endosc Percutan Tech. 2016; 26 (6): 523–30.

33.   Gorgun E., Ozben V., Costedio M., Stocchi L., Kalady M., Remzi F. Robotic versus conventional laparoscopic rectal cancer surgery in obese patients. Colorectal Dis. 2016; 18 (11): 1063–71.

34.   Ye S.P., Zhu W.Q., Liu D.N., Lei X., Jiang Q.G., Hu H.M., et al. Robotic- vs laparoscopic-assisted proctectomy for locally advanced rectal cancer based on propensity score matching: Short-term outcomes at a colorectal center in China. World J Gastrointest Oncol. 2020; 12 (4): 424–34.

35.   Ferrara F., Piagnerelli R., Scheiterle M., Di Mare G., Gnoni P., Marrelli D., et al. Laparoscopy versus robotic surgery for colorectal cancer: a single-center initial experience. Surg Innov. 2016; 23 (4): 374–80.

Sergey L. Dzemeshkevich
MD, Professor (Moscow, Russia)
Medicine today

Уважаемые коллеги! Представляем оргкомитет 17-го Национального конгресса терапевтов (с международным участием) , который состоится 12-14 октября в МВЦ "Крокус Экспо" (павильон 3, Зал 20, г. Москва). · Президент Российского научного медицинского общества терапевтов,...

IV Съезд онкологов Московской области 7 октября 2022 года Активное развитие онкологической службы позволяет эффективно решать проблемы, возникающие на всех уровнях оказания помощи пациентам с онкозаболеваниями. Одним из успешных примеров такого взаимодействия является IV...

II Всероссийская конференция с международным участием "Воспаление глаза" 12 ноября 2022 года, Москва Воспалительные заболевания глаза - широко распространенная и многогранная проблема, с которой может столкнуться в своей практике любой специалист. Найти оптимальные алгоритмы...

Journals of «GEOTAR-Media»